Frequent Emergency Department Visitors Associated With a Pain-Discharge Diagnosis

Area of Science:

• Emergency Medicine
• Health Services Research
• Pain Management

Background:

• Emergency departments (EDs) face rising patient visits and extended stays.
• Managing frequent ED users with pain is a significant challenge in time-limited settings.

Purpose of the Study:

• To characterize frequent emergency department (ED) users who present with pain-related diagnoses.

Main Methods:

• Retrospective longitudinal cohort study of ED visits from two sites (September 2016 - August 2018).
• Frequent users defined as >= 4 visits/year; categorized by pain visit frequency.
• Descriptive statistics and regression analysis used for demographic and clinical characteristics.

Main Results:

• 11.3% of patients were frequent users, accounting for 38.9% of all ED visits.
• Frequent pain users were more likely to be middle-aged (OR 1.70), female (OR 2.43), and commercially insured (OR 1.91).
• Super users (>= 10 ED encounters/year) were significantly more likely to be frequent pain users (OR 23.66).

Conclusions:

• Identifying characteristics of frequent ED users with pain is crucial.
• Findings can inform community-based interventions to reduce episodic care.
• Improved care coordination and management can result from understanding these patient profiles.